MUSCO-01-Introduction肌肉骨骼系统课件.pptVIP

INTRODUCTION TO MUSCULOSKELETAL;Definition: Rheumatologic (or Rheumatic) Disease: diseases characterized by pain and inflammation in joints and connective tissues, often referred to as “collagen-vascular diseases”. ;Diversity of Rheumatologic Diseases: Common and Uncommon Diseases Involving Inflammatory and Immune Responses;Introduction to Rheumatology: Historical Perspective;The Painter’s Family Jacob Jordaens (1593-1678);Evidence of: Rheumatoid Arthritis;The Virgin with Canon van Der Paele, 1436 Jan van Eyck (1385-1440);Evidence of: Temporal (Giant Cell) Arteritis;Musculoskeletal Complaint;Goals of Assessment;RED FLAG CONDITIONS;Articular vs. Periarticular ;Peri-/Non-articular Pain;Inflammatory vs Noninflammatory;Formulating a Differential Dx;Mono/Oligo vs Polyarticular;History: Clues to Diagnosis;Rheumatic Review of Systems;Rheumatic Review of Systems;Onset Chronology;Location;Musculoskeletal Complaint;;;;;;;;;;;;;;;;;;;;;;;;;Rheumatologic Assessments;RHEUMATOSCREEN PLUS;Presbyterian Hosp. CheapoScreen;Further Investigations;Acute Phase Reactants; ESR : Introduced by Fahraeus 1918 Mechanisms: Rouleaux formation Characteristics of RBCs Shear forces and viscosity of plasma Bridging forces of macromolecules. High MW fibrinogen tends to lessen the negative charge between RBCs and promotes aggregation. Methods: Westergren method Low ESR: Polycythemia, Sickle cell, hemolytic anemia, hemeglobinopathy, spherocytosis, delay, hypofibrinogen, hyperviscosity (Waldenstroms) High ESR: Anemia, hypercholesterolemia, female, pregnancy, inflammation, malignancy,nephrotic syndrome;Extreme Elevation of ESR;ESR Age;ACP Recommendations for Diagnostic Use of Erythrocyte Sedimentation Rate;Case;Case;Case;Case;Case; DDx of Migratory Arthritis;Hepatitis B Associated Arthritis;What am I?;Thank you